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PROGRAM/ELEMENT <br />___ <br />*4 0 <br />U-PA C(Ci <br />c] r £ ct t sr£> cJ ±LfLl^C <br />z) /<?1 ^■4x1 c. i^. <br />/oca 'hrS'a <br />L~' <br />^o, W7 , rl(^4 Cs <br />-hy-cC^sh c(Q lr\7 <br />~2> <br />RECEIVED BY: <br />2-/f 3/?7 <br />PHS177 (4/96) <br />. Lc 4- 5 <br />4^ <br />lS~f~ 'r <br />The marked items represent California State Code violations and shall be corrected as follows: <br />4Z/g <br />hs -h v-e <br />C^t'D^ <br />TIME OUT <br />Cx/5 <br />NAME <br />c f rr c- ^ei c^____ <br />LOCATION <br />Pt3oo E ■ flCnT <br />MAILING ADDRESS <br />yy t^. 2-/ <br />OWNER/OPERATOR <br />V-c. /^ c - T <br />t <y ■ hk <br />PROS NUMBER <br />3^0/0^^ <br />TIME IN <br />__________ <br />-S~c/JS^ 4^%-^ ... <br />c Y <br />/ t <br />zec-e^w’c/ Y-jQ> <br />js. <br />yj ZV (✓ ! tJX* S I <br />3 s. <br />~3 <br />y Z3/77 - <br />9(e~fl <br />SMALL wATER SYSTEM OFFICAL INSPECTION REPORT <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 E. WEBER AVENUE, PHONE (209) 468-3420 <br />P.O. BOX 388, STOCKTON, CA 95201-0388 <br />7^ <br />o <- c / <br />-io <br />L/.X. IE - <br />ENVIRONMENTAL HEALTH SPECIALIST <br />PAGE OF <br />-T-f ( rc< / <br />A « r <br />7 z <br />/A O (J ! Io Ct C I o <br />L' <br />7^ —> <br />DATE <br />RECHECK DATE <br />C< Cy T <br />/ <br />g? hr